Active NPI
Jody C Lin, D.M.D.
- Dentist
- Henderson, NV
National Provider Identifier
1821149428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5341
- Practice address
- 10925 S Eastern Ave
#130
Henderson, NV 89052-4949 - Phone
- (702) 222-9700
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5341 | NV | Primary |
Addresses
Primary practice location
10925 S Eastern Ave
#130
Henderson, NV 89052-4949
Mailing address
840 Valley Brush St
Henderson, NV 89052-3813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150808015872 | CA | Order and Referring Only - Dentist | 4789998436 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5341 | NV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camel Kids Dentistry | Past | Accepting new patients | |
| Toothfairy Children'S Dental | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Henderson, NV
- NPI 1841137627
-
- Dentist
- Henderson, NV
- NPI 1407212624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197244800000",
"number": "1821149428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 VALLEY BRUSH ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10925 S EASTERN AVE",
"address_2": "#130",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890524949",
"telephone_number": "702-222-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "JODY",
"middle_name": "C",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "5341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
- Limitless Behavioral Health & ABA Associates LLC
- Limitless Behavioral Health & ABA Associates LLC
- Limitless Behavioral Health & ABA Associates LLC
- Ferdinand Limtao, NURSE PRACTITIONER
- Lin Henderson Dental Group, PC
- Kathy Lin, DDS, MS
- Jessica Lincoln, LCSW
- Linda Hawley LLC
- Linda Hawley, L.L.C.
- Linda L. Johnson MD, LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.